Tarlov cysts are sacs filled with cerebrospinal fluid which affects the nerve roots in the sacrum, or the group of bones at the base of the spine. Tarlov cysts can be distinguished from other cysts with the wall of nerve fibers in the cyst cavity itself. These cysts show no symptoms and are often discovered incidentally when MRI studies are done for other ailments.
What causes Tarlov Cyst?
Tarlov Cyst may develop due to the following causes.
- Sudden trauma to the spinal cord.
- Heavy weight lifting.
- Increased pressure of cerebrospinal fluid.
- Epidural anesthesia.
- If cerebrospinal fluid gets blocked.
- Child birth
- Any traumatic incident such as automobile accident or sudden fall.
Symptoms of Tarlov Cyst
The symptoms of this condition vary from patient to patient.
Here are the symptoms of this condition.
- Muscle weakness
- Loss of motor function of the brain
- Skin loses sense of touch
- Changes in bowel movements leading to constipation
- Unable to sit for long periods
- Sexual malfunction
- Changes in the functioning of bladders
- Pain in the feet, rectum, abdomen or vagina
- Pain felt during coughing and sneezing
- Abnormal sensation in the legs and feet
- Swelling, tenderness of the lower end of the spine
- Pain in the buttocks
- Radicular pain
How is Tarlov Cyst Diagnosed?
MRI and CT scans are the two main diagnostic tests done to detect the cyst.
MRI SCAN
MRI imaging provides better picture of the density of tissues, multiplanar capabilities, and absence of bone interference. It is noninvasive in nature. Plain films also show the image of erosion of bone taking place in the spinal canal.
CT SCAN
A computed tomography scan is often used in the diagnosis of this condition. Images from CT scan will show sacral erosion, cystic masses and epidural fat distribution.
How is Tarlov Cyst treated?
There are various treatment options available for this condition.
The options are as follows.
- Corticosteroid injections or pain injections for remedy from pain.
- Application of Lidoderm patches to the sacral area to remove discomfort and pain.
- Transcutaneous electrical nerve stimulation which sends electric impulses through the skin to control the pain.
- Medications such as pain killers, anti-depressants and antiseizure medications.
- Cyst aspiration can be done with a needle to drain the cyst which will relieve the symptoms.
- Surgery is also opted at times. The techniques include laminectomy, cyst, microsurgical cyst fenestration, nerve root excision and imbrication.
What is the prognosis?
Tarlov Cysts can show complications even after surgery. Leaking of CSF is the most common complication, though in some cases it gets healed by itself. Acute pain might occur in the nerves due to nerve root compression which if left untreated might result in neurological damage permanently. Changes in the lifestyle are required. If all treatment options have been tried out, a physician can be consulted for undertaking pain management strategy. Support groups can help improve the quality of life for the patient.
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